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Thulium laser to endoscopically manage a rectal erosion and intraluminal mesh migration after ventral rectopexy
  1. Lorenzo Dioscoridi1,
  2. Francesco Pugliese1,
  3. Camillo Leonardo Bertoglio2 and
  4. Massimiliano Mutignani1
  1. 1Digestive and Interventional Endoscopy Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
  2. 2Oncological and Mininvasive Surgery, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
  1. Correspondence to Dr Lorenzo Dioscoridi; dioscoridi.lorenzo{at}


Rectal erosions after ventral rectopexy (VR) is an uncommon but challenging adverse event and can be associated with partial migration of the mesh into the intestinal cavity. Re-do surgery is difficult and often provides colostomy and/or anterior rectal resections. However, no alternative solutions are described in the available literature. An 82-year-old woman presented to our hospital for rectal erosion and intraluminal migration of the mesh placed at a 1-year laparoscopic VR. We performed an innovative totally endoscopic approach, using thulium laser and two endoscopes, that led to a successful removal of the mesh. The described mini-invasive technique can be an effective alternative to surgery in tertiary referral centres.

  • endoscopy
  • gastrointestinal surgery
  • general surgery

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  • Contributors LD performed the procedure together with FP and CB. LD wrote the paper and revised the paper after reviewers’ comments. FP found the images. CB created the video. MM revised the final form of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.